Thu
Mar 20 2014
03:18 pm

I was rather dismayed today when I got a link to this Seattle Times article on how Cancer Centers are being excluded by some exchanges.

In all, only four of 19 nationally recognized comprehensive cancer centers that responded to AP's survey said patients have access through all the insurance companies in their state exchange.

I'm sorry, but this is a big problem. For years, insurance companies denied coverage to cancer patients. Now this. Another way insurance companies have found to deny treatment to cancer patients.

It should not be up to each individual signing up for health insurance to research to find out if a cancer center accepts insurance bought on the Exchange. What about folks signing up on the Exchanges that have not yet been diagnosed with cancer? How do those folks know to do the extra research? They don't.

So, what does one insurance company say about this?

In a statement, Anthem said its network was based on research involving thousands of consumers and businesses. "What we learned was that people are willing to make trade-offs in order to have access to affordable health care," the company said. "Our provider networks reflect this."

Alrighty!

PS -- (link...)

B Harmon's picture

cancer centers

When I was living in Houston TX and diagnosed with cervical cancer, I did not rush to MD Anderson. I went to a group of oncologist that were all trained at MD Anderson that were affiliated with a local hospital chain and very convenient.

In my work as a case manager for an insurance company during the 1990s, I had many a chance to follow patients that went to MD Anderson. Generally they are the 'last hope' facility, providing treatment for those that have tried other routes but their cancer was not responding to conventional treatment.

In addition, they can offer clinical trials, if you are lucky enough to get into one (and to get the real stuff and not the placebo) even though you can get on those trials elsewhere such as our own UT Medical Center. But what I noticed about MD Anderson is that they never gave up, continuing to aggressively treat patients to the point where there was no quality of life left. They were too sick to enjoy the extra 6 weeks the extreme treatment gave them, often riddled with excruciating side effects. The people that I was following would be there inpatient for weeks if not months, very sick.

With all insurance companies, if you have a good doctor to be your champion, you can appeal any decision or network issue till they relent. It takes lots of doctor- medical director conversations to make it happen.

CE Petro's picture

I hope you are clear of the

I hope you are clear of the cancer, Becky.

But, with breast cancer, well, the survival rates between the races is vastly different.

Did you know that 40% of black women are more likely to die from breast cancer than white women, even though they are less likely to get breast cancer? Black women are also more likely to get a more aggressive form of breast cancer than white women. Did you know that low-income breast cancer patients have a 5-year survival rate that is 9% lower than higher income breast cancer patients? Racial disparity, and the widening survival gap between racial groups is alive and well and growing, when it comes to breast cancer. (BTW, Memphis has the highest disparity rate, followed by Los Angeles, when 20-30 years ago there was no gap in the survival rate)

The more access that is denied will ensure the continuation of that widening survival gap, at least where breast cancer is concerned. And since that was my particular cancer, yes, I do watch care and access to care quite carefully.

cwg's picture

I agree this sucks, but I

I agree this sucks, but I also think isn't going to as bad as all that.

A) Most cancer patients get treatment at their local hospital.

B) Even if their insurance would cover treatment at MD Anderson or Sloan Kettering, that doesn't mean they can afford the expenses of non-local treatment: hotel rooms, airfare, childcare, etc. Most people can't.

I think the net benefit of more people having access to any kind of cancer care covered by insurance at all, plus the magical ability to not lose or be refused insurance because of your present or past cancer status, outweighs a handful of big hospitals losing some but not all by any means coverage. I mean, I certainly hope the regulators crack down and close the loophole, and do it soon, but the reality is the overwhelming majority of cancer patients will not need to go to one of these few institutions, and many that already were going to them didn't have their insurance covering it then either.

Pam Strickland's picture

My dear friend Laura Newman

My dear friend Laura Newman died in January 2013 after fighting Stage IV breast cancer for seven years. She was treated for the first six years in Little Rock and did just fine. The last year she sought treatment at MD Anderson. It was completely experimental, but it was the only hope she had at that point. It was helping, but suddenly it wasn't. And the end came very quickly. The good thing about the treatment at MDA was that they were able to provide treatment for some of the more bothersome side effects of the extreme treatments of long term chemo treatments, do she was more comfortable in the last year because of their expertise. Their was expense involved with the travel, but she had planned well and did OK. Plus there is a group of private pilots that donate time to take patients to MDA and they took herost of the time.

But the truth is most of the time I see women here who get treatment in Knoxville and recover with treatment locally without the need to go elsewhere. My friend Cathie finished her last radiation yesterday. it's been a long year of chemo, surgery, more chemo and then radiation. She'll take a break and then do reconstruction. But like many thousands of women, she doesn't need to go out of town for treatment.

Dwayne's picture

Apologists

Damnit, what is wrong with you people. THE EMPEROR HAS CLOTHES.

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